State policies and language access in California's HMOs: Public reporting and regulation of HMOs' language services

Objective. Describe the status of language access services for California's limited English proficient (LEP) health maintenance organization (HMO) members within the context of voluntary public reporting and anticipated state regulation. Study design. Descriptive analysis of longitudinal data provided by health plans. Methods. Retrospective, descriptive analysis of responses to voluntary annual/biennial surveys of commercial, Medicare, Medicaid, and Healthy Families HMOs, 2003-2008. Results. From 2003 to 2008, during California's public reporting of HMO language services, the percentage of HMOs providing in-person interpretation free of charge to consumers increased to over 80% across all product lines. By 2008, the percentage of commercial HMO plans matching new LEP members to providers by language increased to 70%, while 79% provided telephone interpretation services in at least seven languages. Conclusions. Increasingly HMOs provide language access services for LEP Californians, perhaps resulting from public reporting and anticipated state regulation, although similar trends in other states cannot be ruled out.